Analysis of Outcome of Surgical Management in Ileal Perforation with and Without Ileostomy
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2016, Vol 4, Issue 4
Abstract
Abstract: Ileal perforation peritonitis is common surgical emergency in the Indian subcontinent, but the choice of procedure continues to be debated. Various strategies are being used to deal with ileal perforation. The aim of the study is to compare the results of two surgical modalities of treatment, as effective management of the disease to help in decreasing morbidity and mortality associated with disease. It is a prospective study from May 2013 –May 2015, involving 40 patients admitted from casualty and surgical OPD with diagnosis of ileal perforation peritonitis at Basaveshwara Teaching and General Hospital. Patients were divided into two equal groups. Patients in group 1 were managed by simple closure/ resection – anastomosis and in group 2 patients were managed by proximal defunctioning ileostomy to protect simple closure/ resection of the perforation. Severity of disease was assessed by using APACHE score. All patients were followed for post-operative complications. The most common cause of perforation was typhoid(45%), followed by non-specific (42.5%), tuberculosis(7.5%), traumatic(5%). Simple closure of perforation was done in 30% patients, resection – anastomosis was done in 20% and ileostomy proximal to simple closure/ resection-anastomosis was done in 50%. Postoperative complication rate in group 1 was 60% and 10% mortality. In group 2 complication rate was 85% and 20% mortality. Group2 patients had additive complication rate of 80% related to ileostomy. In patients with single perforation of upto 2cm with minimal contamination simple two layered closure of perforation is preferred. In patients with large perforations >2cm, multiple perforations, diseased unhealthy bowel, extensive peritoneal contamination, resection anastomosis is advocated instead of resection anastomosis with proximal temporary loop ileostomy due to its less morbidity related to ileostomy complications and need of second surgery for ileostomy closure. Keywords: enteric fever, ileal perforation, peritonitis, loop ileostomy, resection-anastomosis
Authors and Affiliations
Dr. V. S Kappikeri, Dr. Vinayak V. Ingalalli
Keywords
Related Articles
- EP ID EP370950
- DOI -
- Views 93
- Downloads 0
About the association of different methods of learning in the training of medical students in a Pathology Lab
Every year, we receive in our Department of Pathology 7 groups of medical students in the third year of medical study who try to achieve the educational targets specified in their portofolios. In our department, we use m...
A Bibliometric Analysis of Comparison of Google Scholarand Pubmed Databases for Oral Health Related Keywords
Abstract: Google Scholar has been met with both enthusiasm and criticism since its introduction in 2004. However, several authors suggest that Google Scholar should not be the first or sole choice when searching for pati...
Epidemiology of breast cancer in young women in the West of Iran
The incidence of breast cancer (BC) in young women (age < 35) is low. The aim of the present study was to investigate clinico pathological characteristics in young BC patients (35 and less than 35 years old) for the firs...
Communication and collaboration's nurse with physician from the perspective of hospitals nurse in Neyshabur City 2013
Interactions between physician and nurse are discussed as an indicator to present the desirable care from the patient. The present study was conducted with aim of clarifying the status of communication and collaboration'...
Comparative Study between Exteriorization of Uterus during Cesarean Section Versus Intraperitoneal or in-Situ Repair
The objectives of this study is to assess intraoperative and postoperative advantages and disadvantages following exteriorization of uterus as compared to those with intraperitoneal or in-situ repair and to assess intra...